Aula de Itziar Larizgoitia Jauregui, Coordenadora de Pesquisa e Gestão do Conhecimento do Programa de Segurança do Paciente da Organização Mundial de Saúde (OMS), durante o II Seminário Internacional sobre Qualidade em Saúde e Segurança do Paciente - evento do Qualisus - nos dias 13 e 14 de Agosto de 2013, no Ministério da Saúde, em Brasília.
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Estratégias sobre Segurança do Paciente: Cuidados de Saúde para todos, sempre, em todo lugar
1. Strategies on Patient Safety: safe healthcare for
everyone, every time, every where
Overview of the WHO Patient Safety Programme
Dr Itziar Larizgoitia
WHO Patient Safety Programme
For Ministry of Health Brazil, Brasilia, August 2013
3. ** Incidence
Average in Europe: 7.1% patients
ECDC, Comm Dis Report 2008
Prevalence of HAI in developed countries
4. Prevalence of Healthcare Associated Infections in
transitional & developing countries
Pooled prevalence 15.5% patients
Lancet, 2011; 377: 228–41
5. IBEAS: A study on 5 Latin-American Countries.
And, 2 out 10
suffered an incident
during their hospital
stay
On average, on the day of the survey, 1 in 10 inpatients
showed the consequences of a patient safety incident
Death
Permanent Disability
Low
Disability Moderate Disability
Argentina
Perú
Colombia
Costa Rica
México
6. Unsafe injection practices: A plague of many
health systems
■ Over-prescription of injections
• In some situations, 9 out of 10 patients
presenting to a primary healthcare provider
receive an injection, over 70% of which are
unnecessary or could be substituted by oral
medications
■ Reuse of syringes and needles in the
absence of sterilization exposes
millions of people to infections
■ Each year unsafe injections cause an
estimated 1.3 million early
deaths, a loss of 26 million years of
life, and an annual burden of
USD 535 million in direct medical
costs.
7. Every year, an inadmissible
number of patients suffer
injuries or die because of
health care. Most of these
injuries are preventable
8. The burden of unsafe care:
Global Priority areas
■ Counterfeit and substandard drugs
■ Problems with communication and coordination
■ Latent organizational failures
■ Inadequate competence, training and skills
■ Maternal and New Born Care
■ Unsafe Injection and Blood Practices
■ Poor Safety Culture
■ Lack of Human Factors design
■ Misdiagnosis
■ Insufficient cost-effective risk-reduction strategies
9. Systems' Approach versus Individual Blame
“Humans fail because the
systems, tasks and
processes in which they
work and operate are
wrongly designed"
Dr Lucian Leape, testifying to the US President’s Commission
on Consumer Protection and Quality in Health
10. To coordinate, disseminate and accelerate improvements in
patient safety worldwide
WHO Patient Safety is set up as a Special
Programme following WHA Resolution 55.18 in
2002
11. The vision
Every patient receives safe health care,
every time and everywhere.
The mission
of WHO Patient Safety Programme is to coordinate,
facilitate and accelerate patient safety
improvements around the world.
15. Fourteen hospital-to-hospital partnerships across Africa are now implementing
improvements alongside partners from the UK, France and Switzerland. Patient
Safety Situational Analysis have been used to co-develop improvement plans that
focus on front line realities.
16. Three Core Objectives
African Partnerships for Patient Safety
European
APPS
Hospital
African
APPS
Hospital
Objective 1:
PARTNERSHIP
STRENGTH
Objective 2:
HOSPITAL PATIENT
SAFETY
IMPROVEMENTS
Objective 3:
NATIONAL PATIENT
SAFETY SPREAD
19. Developing and motivating global campaigns
through evidence based solutions and local
engagement & commitment
20. First Global Patient Safety Challenge
Clean Care is Safer Care
WHO Guidelines for Hand Hygiene in
Health Care
21. Making it easier to
■ understand
■ remember
■ practice
the hand hygiene
indications at the point
of care
The My Five Moments approach
Sax H, Allegranzi B, Uçkay I, Larson E, Boyce J, Pittet D. J Hosp Infect 2007;67:9-21
27. Curso online: Introdução à investigação sobre segurança
do paciente/doente – The sessions
Sessão 1: Segurança do Paciente/Doente, o que é?,
Claudia Travassos, 1°de março de 2012
Sessão 2: Princípios da investigação em segurança
do paciente/doente, Mônica Martins, 8 de março de 2012
Sessão 3: Medir o dano, Walter Mendes, 15 de março de
2012
Sessão 4: Compreender as causas, Walter Mendes,
22 de março de 2012
Sessão 5: Identificar as soluções / Implementação,
Maria João Lage, 19 de abril de 2012
Sessão 6: Avaliar o impacto, Paulo Sousa, 26 de abril de
2012
Sessão 7: Transpor a evidência em cuidados mais
seguros, José Fragata, 3 de maio de 2012
Sessão 8: Aprofundar o conhecimento em
segurança do paciente,Paulo Sousa, 10 de maio 2012
31. Universal health coverage is our new priority
“I regard universal health coverage as the single most
powerful concept that public health has to offer. It is
inclusive. It unifies services and delivers them in a
comprehensive and integrated way, based on primary health
care.”
Dr Margaret Chan, WHO Director-General
32. PSP New STRATEGIC AREAS
32
Universal Health Coverage & the
Safety/Quality Agenda
Ageing and Safety – Chronic
care, Palliative care and others
Primary care and patient safety
33. Strategic
Objective 1
To provide global leadership for patient safety
Strategic
Objective 2
To harness knowledge, expertise and
innovation to improve patient safety in health-
care settings
Strategic
Objective 3
To engage health care systems, non-
governmental organizations, civil society and
the expert community in the global endeavour
of making health care safer
Quality and Patient Safety strengthened
34. Priority work
1. Reflecting on a strategy for health care delivery
2. Ageing and patient safety initiative - Consensus review
report on priorities in patient safety and quality for the
elderly
3. World Health Report on Safety and Quality of Clinical
Care
35. Safer Primary Care:
A Global Challenge
Inaugural Meeting of the Safer Primary Care Expert Working
Group
World Health Organization, Geneva 27th - 28th February 2012
38. Building capacity for patient safety of health-care
leaders, managers, providers educators and students.
WHO has developed:
1. WHO Multi-professional Patient Safety Curriculum
Guide: strengthen academic capacity to teach patient
safety to undergraduate and postgraduate students
2. Comprehensive patient safety training workshops of
health-care educators, leaders, providers, students,
and train-the trainers
3. eLearning on the WHO platform based on the courses
of the Multi-professional Patient Safety Curriculum
Guide planned to start in 2014
4. Development of a Patient Safety Guide for Leaders
WHO PATIENT SAFETY: EDUCATION AND TRAINING
45. Turning the World Upside Down: Partnerships
• Shared learning
• Co-development
Hospital-to-hospital partnerships can be used to
improve the safety of service delivery. Solutions can
be co-developed and learning and knowledge flows
both ways. Tools and resources are now freely
available to take action to improve patient safety
through such partnerships.
46. Brazil Collaboration to hospital-
hospital African Partnerships
■ Strengthening Patient Safety
in Portuguese-speaking
African Hospitals
■ To set up a WHO CC for
Global Health through South-
South Collaboration at
FIOCRUZ Global Health
Center, Support from
PROQUALIS
■ Brazilian Hospitals to support
Portuguese-speaking
countries’ hospitals in Africa
In collaboration with e-Portuguese Network
47. Fostering a global patient-led movement to encourage
partnership, promote empowerment and inspire action on
patient safety around the world.
48. WHO invites Member States,
healthcare professionals,
academics, patients and
citizens to:
- Foster the patient safety culture
- Adopt effective solutions
- Roll out commitment & engagement
To achieve Universal Health Coverage of
safe and quality care